Surgical Removal of Retained Roots of Tooth #27
Surgical Removal
Chief Complaint
Patient reports pain on the upper left side and suspects the upper wisdom tooth as the cause.
Clinical Findings
Tooth #27
Retained, grossly carious roots
Very TTP and TTPp
Mobility within normal limits
Probing depth within normal limits
Gross subgingival / possible subcrestal caries
Large periapical lesion
Fractured, 3-rooted with long, wide, flattened MB and DB roots
Additional CBCT Findings
Buried retained #11
Exposed and deviated #13 crossing the root of erupted #12
Left maxillary sinus: high fluid level + blocked nose
Possible left maxillary sinusitis (KIV)
Treatment Plan
LA surgical removal of retained #27 roots
Post-operative CBCT to confirm complete removal and assess adjacent structures
Pre-operative Assessment
Pre-op CBCT taken and reviewed
Findings explained to patient
Risks discussed: potential paresthesia, sinus-related complications
Patient understood and agreed to proceed
Informed consent taken
Anesthesia
Local anesthesia administered (left maxillary region)
Surgical Procedure
Patient cleaned and draped
Incision made, buccal flap raised
Bone guttering performed
Tooth sectioning as needed
#27 elevated in 2 pieces
Curettage and saline irrigation
BSS ×3 placed for secondary closure
Hemostasis achieved
POI provided
Post-operative Assessment
Post-op CBCT taken
No remnants detected
IDN and adjacent teeth not involved
Patient reassured and discharged with instructions